Chamber and committees

I agree with that.

I will say a few words before I turn to Professor Leitch.

It is critical that our healthcare system is able to meet the needs of all individuals, regardless of the health condition that they face, recognising the necessity of interventions where they are appropriate. That is one of the reasons why we have to manage and suppress the prevalence of Covid—the more Covid cases there are in our hospitals, the less space there is for other conditions to be addressed. That is the central argument that ministers have set out to the committee, the Parliament and the public on the steps that we have taken to tackle Covid. We have taken appropriate and proportionate action in order to enable our health service to timeously meet the needs of all constituents, such as the person Mr Whittle mentioned, while also dealing with the pressures that come from Covid.

Those are fundamental questions about the capacity of the health service, on which I invite Professor Leitch to give some more detail.

Those messages are communicated by Government. Our clinical advisers have been at the forefront of arguing for the rationale for vaccination and the booster programme, and ministers likewise. At the heart of many of the interventions that we have made—whether on public communication or policy interventions such as vaccine certification—the purpose has been to increase the level of vaccination in the population because it is a compelling protection against the virus. I can assure Mr Fraser that those messages have been and will be communicated by ministers.

Some of the endless speculation about these matters sometimes muddies the waters. It has been crystal clear for a long time now that vaccination is critical as an obstacle to circulation and to protect people against the virus. When we go through all the issues about extra bits of data, it almost leaves the public thinking that there is something that they or the Government are missing about the data, whereas it is actually crystal clear: if you get vaccinated, you have more protection against Covid.

Mr Whittle raises legitimate points, which come back to points that I made in my previous answer. We must ensure that the needs of the population are met by the national health service. It is the fundamental founding commitment of the NHS that free treatment be provided at the point of need when individuals experience that need. Covid poses a threat to that, because it takes up capacity in our hospitals. More than 1,500 patients are in hospital with Covid. If Covid was not a problem for us, those 1,500 beds could be used for other purposes.

Therefore, the more we can get on top of Covid and reduce the circulation of the virus, the better, because that creates space for patients, such as the people on whose behalf Mr Whittle argues today and, for that matter, has argued consistently for some considerable time.

The Government has tried to take all the necessary steps to sustain the engagement of critical services for people with conditions that have a life-threatening impact. Along with clinicians and health services, we have worked hard to sustain cancer services. Obviously, for acute presentations of life-threatening conditions, the health service is there to meet people’s needs. That is why we look very carefully at the numbers of people who are in ICU with Covid, because we need space in ICU for people who come in because of heart attacks, brain haemorrhages or whatever it happens to be.

Mr Whittle is right to raise those issues, and I assure him and the public that the Government, in its management of Covid, has the patient group that Mr Whittle raises very much in our minds. We want to ensure that their interests are protected.

Good morning, convener. I am grateful to the committee for the opportunity to discuss a number of matters, including updates to Parliament on Covid-19, and to make some opening remarks before taking questions.

As the First Minister set out on Tuesday, although omicron is continuing to cause extremely high levels of new cases and we must remain careful, there are grounds for cautious optimism that our current additional measures and the efforts that are being made by people across Scotland are having an impact. Last month, our central projection was that new infections could reach 50,000 a day by early January. So far, that has not materialised, and we estimate that the total number of daily infections may be around 30,000. We are also seeing that the numbers of cases confirmed by a polymerase chain reaction test have fallen in all age groups, except the over-85s. That is encouraging, and it gives us some hope that cases might be at or close to the peak. Further, although the number of people in hospital with Covid has continued to increase over the past week, there are signs that the rate of increase may be starting to slow.

In line with our guidance that was set out last week, people without symptoms who test positive with a lateral flow test no longer need to secure a confirmatory PCR test. That means that the current daily numbers are capturing fewer positive cases than before. To address that, Public Health Scotland will, from today, augment its daily reports to include the combined figure for the number of people who have recorded a first positive PCR or lateral flow test. That additional data will allow us to assess the trend in cases more accurately. I encourage members of the public to continue to record their lateral flow results, whether they are positive or negative. That can be done very easily through the United Kingdom Government website, by searching for “report a lateral flow test”.

Although we must remain careful and cautious, the Cabinet agreed on Tuesday to begin lifting the additional protective measures that were introduced before Christmas. We will do so in a phased manner, and further dates will be announced in due course. From Monday 17 January, the attendance limits on large-scale outdoor events will be removed. Certification will remain in place for events and venues that were previously covered by the scheme, and we are asking event organisers to check the certification status of more people attending events. From Monday, for the purposes of certification, the requirement to be fully vaccinated will include having a booster if the second dose was more than four months ago.

For the time being, baseline measures that were in place before the emergence of omicron, such as wearing face coverings in indoor places and working from home where possible, will remain in place. For the immediate period ahead, our advice remains that people should limit their contact with other households and, in particular, not meet indoors with more than three households. We are not asking people to cut all social interaction, but reducing contacts and prioritising who we meet will help to reduce the risk. Our advice remains to take a lateral flow test and report the result when meeting others.

Finally, the First Minister confirmed that the Scottish Government intends to publish a revised strategic framework in the next few weeks. I will update the committee further once that has been published.

I am happy to answer any questions that the committee may have.

Obviously, we will carefully monitor the impact of schools returning. That is central to the approach that the Government is taking, because we recognise that their return marks a gathering of individuals within our society at a fairly high level. As we know, the meeting of individuals from multiple households leads to the spread of the Covid virus.

We will monitor the situation closely. That is why we are taking a phased approach to the relaxation of restrictions. Although the current data is encouraging, the data could be influenced by the effect of schools returning, and we will now only just be beginning to see the effects of that in the numbers, to the extent that that will have an effect.

We do not have authorisation from the Joint Committee on Vaccination and Immunisation for the widespread vaccination of children who are in the five-to-12 age group. The JCVI has not made the case for that and, as the committee will know, we look to and implement the advice of the JCVI. The JCVI has indicated that it is appropriate to vaccinate some children in that group, particularly if the child might be clinically vulnerable or living in a household with individuals who are clinically vulnerable. We are taking steps to implement those recommendations, as has been confirmed in Parliament.

On the final part of your question, ventilation is ostensibly a local authority priority. We have been engaging with local authorities on ventilation over the past 20 months, and we have required them to enhance the monitoring of air quality in schools to ensure that we have a good understanding of where some of the ventilation requirements might need to be in place. On Tuesday, the First Minister announced further expansion of the funding available to local authorities to enhance ventilation schemes, should that be required. Local authorities have undertaken extensive audits of ventilation requirements on a classroom-by-classroom basis, and we expect them to act accordingly to address any ventilation weaknesses that emerge out of those surveys.

Obviously, the data will vary from area to area. I am absolutely satisfied that the Government and health boards have put in place adequate opportunities for individuals to secure the booster jag. The level of performance has been very high. We have had surplus capacity, so there has been absolutely no difficulty in getting an appointment for people.

In some circumstances, there will obviously be a time lag. If individuals were slower in coming forward for their first and second doses, they will be delayed in getting their booster dose, because of the time limits that have to be applied. We are not at the end of the booster programme by any stretch of the imagination. It is continuing to vaccinate people on an on-going basis with the appropriate 12-week gap between the second dose and the booster dose. The best way to explain it is that the booster vaccination programme is still a work in progress. I therefore expect those rates of coverage to increase.

We have to continue to intensify the message. One point that concerns me a little is that, if there is a sense that omicron is a less acute variant, that might suggest to people that they do not need to come forward to get their vaccination. However, as Professor Leitch has just explained, there is an absolute necessity for individuals to have the booster vaccination, because it will give them a level of protection that is absolutely critical in dealing with the virus. The Government’s messages will therefore remain resolute about the importance of rolling out that booster vaccination programme in all circumstances and all geographies.

I am in a slightly difficult position on that, because I am not the one making the big song and dance about that data. Mr Fraser set out to the committee that he has been demanding that information for a considerable time. The Government has to respond to demands for information and has an obligation to address issues that members of the Parliament raise. Ministers have made it clear that we take the view, which Mr Fairlie expressed, that there is no particular significance in the difference between people being in hospital because of or with Covid.

We have a massive Covid challenge in our healthcare system, and the more that we can do to tackle the prevalence of Covid, the more we will relieve the pressure on that system. The Government’s messages have been crystal clear about the dangers of Covid. We have ensured that there is an understanding of the severity of the virus, whether omicron or not, because we cannot have a relaxed attitude prevail that omicron is somehow not a big threat. Omicron is a massive threat to our healthcare system and to public health. We have to get that across to people. That is why the Government has taken strong action to protect the public.

We are not in control of all the questions that we are asked, but we are certainly in control of the key messages about the importance of tackling Covid. Your points about the advice from the clinician are correct, Mr Fairlie. If somebody has an underlying condition and Covid, their ability to deal with the underlying condition will be severely compromised by the presence of Covid. We know that clearly from the clinical advice that we have had.

Obviously, a huge amount of effort is put into securing the take-up of vaccination and boosters. I do not have in front of me the breakdown in the over-70s category—

Yes—in whatever circumstance we look at, the Government accepts that argument. We have accepted it for many years and we have taken a number of steps to address it. Some of the available data and detail shows that the challenges that individuals face as a consequence of Covid will be made worse by other weaknesses in their health and fitness.

Mr Whittle makes a strong argument, which the Government accepts, for people to pursue a healthy living approach. Many of our public messages are supportive of such an approach: we encourage people to exercise, look after their health and take preventative action, so that they are in the strongest possible position to withstand the effects of conditions such as Covid or, for that matter, other challenging health conditions that people face in our society. The emphasis on preventative interventions is a core part of the Government’s health strategy and will remain so in the future.